Strategic Payor Relations & Credentialing Leader

lonepeakdentalgroup; Denver (CO); Hybrid; USD 81,000 - 99,000; Full time

Benefits offered by this job

PTO

Benefits package

Job summary

Lone Peak Dental Group in Denver, CO is seeking a Director of Payor Relations & Credentialing to lead provider credentialing, payor enrollment, and insurance contracting for a multi-location dental group. Hybrid role in the Denver metro area.

You will build scalable processes, negotiate with Medicaid and commercial payors, mentor a growing team, and align credentialing with organizational growth. Bachelor's degree required; CPCS/CPMSM a plus; 7+ years in dental credentialing.

Qualifications

• 7+ years in dental credentialing with payor experience.
• Negotiated payor contracts for commercial and Medicaid.
• Experience leading credentialing across multi-location dental groups.
• Bachelor's degree required; CPCS or CPMSM a plus.

Responsibilities

• Lead credentialing and enrollment for providers across the organization.
• Oversee payor relations, contracting, and Medicaid enrollment.
• Build scalable processes for growth and new states.
• Mentor credentialing team and monitor KPIs.

Skills

Payor relations

Credentialing

Contract negotiations

Leadership

Team mentoring

Data analysis

NCQA CAQH knowledge

Education

Bachelor's degree

Tools

CAQH

Medicaid enrollment systems

Job description

Lone Peak Dental Group in Denver, CO is seeking a Director of Payor Relations & Credentialing to lead provider credentialing, payor enrollment, and insurance contracting for a multi-location dental group. Hybrid role in the Denver metro area.

You will build scalable processes, negotiate with Medicaid and commercial payors, mentor a growing team, and align credentialing with organizational growth. Bachelor's degree required; CPCS/CPMSM a plus; 7+ years in dental credentialing.